Sentinel Lymph Node Biopsy: Past and Present Implications for the Management of Cutaneous Melanoma with Nodal Metastasis

Although significant progress has been made in the understanding of melanoma pathophysiology and therapy, patients with metastatic melanoma still have a poor prognosis. The management of regional nodes remains a matter of debate. By replacing elective lymph node dissection, sentinel lymph node biopsy has revolutionized the treatment of malignant melanoma. In this paper, the history of the procedure is traced, and the indication for completion lymphadenectomy after positive sentinel node biopsy is discussed in light of the recent studies that addressed this issue. The role of adjuvant therapies in the management of patients with stage III melanoma is also discussed.